According to the review, “Topically administered ibuprofen has been shown to be equally effective to orally administered ibuprofen in the treatment of joint and soft tissue injury and is associated with a lower incidence of unwanted gastrointestinal side effects.”

The authors of the review explained that while non-steroidal anti-inflammatory drugs (NSAIDS) have a strong safety profile, those who use them to treat chronic injuries are at a high risk of gastrointestinal side effects. NSAIDS have also been shown to reduce the cardiovascular protective benefits of low-dose aspirin when taken together.

Not many studies have been conducted on topical ibuprofen as a treatment for acute soft tissue injuries, but they cited one March 2002 study in the International Journal of Clinical Practice that found that 75% of patients using topical ibuprofen experience a significant reduction in pain at seven days compared to 39% of patients who received a placebo.

More research is needed especially on how certain factors like skin hydration, skin temperature and disease state can affect the performance of topical ibuprofen.

The researchers wrote, “Further studies are needed to compare topical efficacy to other transdermal delivery methods and skin permeation enhancers. Comparative studies between ibuprofen and other topical NSAIDS (e.g., diclofenac, ketoprofen) are also necessary to determine the optimal pharmaceutical choice for acute soft tissue and articular injury in athletes.”

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Ibuprofen’s Effects on Healing

Elizabeth Hofheinz, M.P.H., M.Ed. • Thu, October 6th, 2016

A new study undertaken at the McKay Orthopaedic Research Laboratory at the University of Pennsylvania has found that ibuprofen does not hamper the supraspinatus tendon’s ability to adapt to exercise, but that one should keep an eye out for a decrease in muscle growth. The research team was led by Louis J. Soslowsky, Ph.D., vice chair for Research in the Department of Orthopaedic Surgery at the University of Pennsylvania.

He told OTW, “There has been a lot of interest from our lab and others on the role of non-steroidal anti-inflammatory drugs (NSAIDs) on tissue injury and repair. However, ibuprofen, the most common NSAID taken, is commonly used by athletes prophylactically, though the effect on relevant tissues is unknown. We developed an animal model of exercise we could use to address this.”

“We divided 167 rats into either exercise or cage activity groups; we also separated them as ‘acute’ (a single bout of exercise followed by 24 hours of rest) and ‘chronic’ (2 or 8 weeks of repeated exercise) response times. Half of the rats received ibuprofen.

“Chronic administration of ibuprofen does not adversely affect tendon properties, but does seem to decrease muscle growth. This is important information for counseling young athletes. The above knowledge may change how doctors and sports trainers advise their patients and student-athletes.”

Does PRP Really Work?

Biloine W. Young • Sat, July 12th, 2014

Doctors are divided on the benefits of platelet-rich plasma injections to treat hamstring muscle injuries. Hamstrings are the muscles located at the back of the thigh that are essential for flexing the hip and knee.

Gustaaf Reurink, a sports medicine specialist with Erasmus Medical Center in Rotterdam, the Netherlands, conducted a study in which researchers gave either two injections of platelet-rich plasma or saline to 80 athletes with hamstring injuries. They tracked both groups of athletes for six months and found that the treatment appeared to have no effect on the time required for them to return to sports or be reinjured.

For both groups the median time in which they could start playing sports again was 42 days. About 15% of both groups reinjured themselves. Reurink and his group published their findings in the June issue of the New England Journal of Medicine.

Randy Dotinga, a HealthDay writer, reported that Lewis Maharam, M.D., a sports medicine specialist in New York City, disagrees, saying that platelet-rich plasma injections have made a big difference. Dotinga quotes Maharam as saying, “When it’s done correctly, patients heal in 2 or 3 weeks maximum and they’re back running.” In the past, he said, pro-football players with torn hamstrings were kept off the field for 8 to 12 weeks to recover using a program of rest and physical therapy.

Dotinga quotes Maharam as suggesting that the researchers did not flood the injured hamstrings via the injections or adjust the amount of plasma based on the size of the injury. Reurink responded that the researchers used the treatment amount recommended by the manufacturer of the plasma materials.

Dotinga notes that there is no research showing that the treatment works on hamstring injuries and, because it is experimental, insurance companies will not cover the cost of the treatment. Single injections, according to Reurink, cost from $500 to $1, 000.

The ideal number of injections for a ham string injury has not been determined. According to the American Academy of Orthopaedic Surgeons, the treatment is being used for other tendon injuries such as tennis elbow, ligament and muscle injuries and knee arthritis.

“New” Ibuprofen May Trump Current Version for Pain Relief

Elizabeth Hofheinz, M.P.H., M.Ed. • Thu, October 20th, 2016

Maybe soon you won’t have to worry about a heart health emergency when you pop an ibuprofen or two. It turns out that a new formulation of ibuprofen—ibuprofen arginate—might allow people to take higher doses without cardiovascular repercussions.

"While more experiments are required, our observations show that ibuprofen arginate provides, in one preparation, a COX-2 inhibitor and arginine supplement, " said Jane A. Mitchell, Ph.D. in the October 14, 2016 news release. Dr. Mitchell is a researcher involved in the work and Head of Cardiothoracic Pharmacology, Cardiothoracic Pharmacology and Vascular Biology Section at the National Heart and Lung Institute at the Institute of Cardiovascular Medicine and Science at the Imperial College in London, England.

Dr. Mitchell told OTW, “Solving the problem of the cardiovascular side effects caused by anti-inflammatory drugs like ibuprofen is one of the most important challenges in drug research today. These side effects are the reason why there are no new drugs in this class and why they are now (since 2011) not used to prevent colon cancer. Our research suggests that L-arginine may prevent the cardiovascular side effects caused by these drugs.”

“If we are right, arginine formulations of anti-inflammatory drugs, such as ibuprofen, will be safer drugs because we think that they will protect the cardiovascular system from the harmful effects that these drugs have in the kidney and in blood vessels. However, there is no need to wait until we know if we are right or not because L-arginine formulations of ibuprofen are already currently available over the counter in many parts of the world. Until we do more tests however we would recommend that the current advice for all forms of ibuprofen be followed.”

“We suggest that arginine formulations of ibuprofen and other drugs in this class, particularly the coxibs, may well be the future of arthritis therapy.”

The researchers gathered data on first round draft picks from 2008 to 2015 in the National Basketball Association including participation in high school sports, major injuries sustained in the NBA, percentage of games played in the NBA, and whether the athlete was still active in the NBA.

According to the data, out of the 237 athletes evaluated, 36 (15%) were considered multisport athletes in high school. Two hundred and one (85%) were single-sport athletes in high school. The multisport athletes played in more total games than their single-sport counterparts (78.4% vs. 72.8%; p < .001). In addition, the multisport athletes were less likely to be seriously injured during their career (78.4% vs. 72.8%; p < .001). Playing multiple sports in high school was also connected to a longer career in the NBA.

The researchers wrote, “While a minority of professional basketball athletes participated in multiple sports in high school, those who were multisport athletes participated in more games, experienced fewer major injuries, and had longer careers than those who participated in a single sport.”

They called for more research to explore further if there really is a long-term protective effect.

New Tool Developed to Assess Athletic Hip Function

Tracey Romero • Wed, September 27th, 2017

New study published in the September, 2017 issue of the American Journal of Sports Medicine confirms that the new Kerlan-Jobe Orthopaedic Clinic Athletic Hip Score is a valid and reliable tool for evaluation of the hip in an athletic population.

According to researchers from the Kerlan-Jobe Orthopaedic (KJOC), this is the first full assessment dedicated to the special nuances in athletic hip function.

They used the results of a pilot questionnaire which was administered to 18 athletic individuals to develop a 10-item questionnaire. The final questionnaire was given to 250 competitive athletes from multiple sports. The athletes were also asked to complete 3 other hip outcomes assessments that have already been validated.

The results showed that the KJOC Athletic Hip Score “showed high correlation with the modified Harris Hip Score, the Nonarthritic Hip Score, and the International Hip Outcome Tool.”

The researchers wrote, “The new score stratified athletes by injury category, demonstrated responsiveness and accuracy, and varied appropriately with improvements in injury category after treatment of injuries.”